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, a <br /> Scc.13.04 RIGHTS OF SUBJECTS OF llATA <br /> Subd. I. Type of data. The rights of individual on whom the data is stored or to be stored shall be as set lorth in this section. <br /> Subd.2. Infonnation required to be given individual. An individual asked to supply private orcontidential dataconceming himselfshall be <br /> informed of: (a)the purpose and intended use of the requested data within the collecting state agency,political subdivision,or sWtewide system;(b) <br /> whether he may rcfuse or is legally required to supply the requested data;(c)any known consequence arising from his supplying or refusing to supply <br /> private or confidential data;and(d)the identity of otlier persons or entities authorized by state or federal law to receive the data.This requirement shal I <br /> not apply when an individual is asked to supply investigative data,pursuant to section 13.82,subdivision 5,to a law enforcement officer. <br /> "I'he commissioner of revenue may olace tlie notice required under this subdivision in thc individual income tax or property tax refund <br /> instructions inscead of on those fonns. <br /> Subd.3. Access to data by individuaL Upon request to a responsible authority,an individual shall be infonned whether he is che subject of <br /> stored data on individuals,and whether it is classified as public,private or contidentiaL Upon his further request,an individual who is the subject of <br /> stored privatc or public data on individuals shall be shown the data without any charge to him and,if he desires,shall be informed of Uie content and <br /> meaning oPdiat data. Atter an individual has been sho�wl the private data and infonned of its meaning,the data need not be disclosed to him for six <br /> months thereatter unless a dispute or action pursuant to tliis section is pending or additional data on the individual has been collected or created. The <br /> responsible authority shall provide copies of the private or public data upon reques[by the individual subject of the data. The responsiblc authoriry <br /> may require the requesting person to pay[he actual cosLs of making,certifying,and compiling the copies. <br /> l he responsiblc authority shall comply immediately,if possible,with any request made pursuant to this subdivision,or within tive days of <br /> the date of the request,e�cluding Saturdays,Sundays and legal hol idays,if immediate compliance is not possible. If he cannot comply with the request <br /> within diat time,he shall so inlorm the individual,and may have an additional five days within which to comply wilh the request,excluding Saturdays, <br /> 5undays and Iegal holidays. <br /> Subd.4. Procedure when data is not accurate or complete. Aii iiidividual may contest the accuracy or completeness of public or private data <br /> concerning himself. To eacrcise this right,an individual shall notify in writing the responsible authority describing the nature ofthe disagrcemenL 'The <br /> responsible authoriry shaU within 30 days either. (a)correct the data found to be inaccurate or incomplete and attempt to notify past recipients of <br /> inaccurate or incomplete data,including recipients named by the individual;or(b)notify the individual that he believes die data to be correcL Data in <br /> dispute shall be disclosed only if the individual's statement of disagreement is included with the disclosed data. <br /> The determination of the responsible authority may be appealed pursuan[to the provisions ofthe administrative procedure act relating to <br /> contested cases. <br /> DATA PRIVACY ADVISORY <br /> In accordance with M.S. 13.04,Subd.2,"Rights of subjects of data",we would like to inform you that your request <br /> for a perniit or license from the City of Orono or any of its departments may require you to furnish certain private or <br /> confidential infonnation. <br /> You are notified that: <br /> 1. The information you furnish will be used to detennine your qualification for the permit or license <br /> requested. <br /> 2. You may refuse to supply data,but refusal may require that the City deny the permit or license. <br /> 3. The information may be shared with other local, state or federal agencies to the extent necessary to <br /> process the permit or license. <br /> 4. If your requested pennit or license requires Council action to approve,some infonnation may become <br /> public. <br /> 5. You have certain rights under M.S. 13.04(available upon request)to review private data on yourself. <br /> 6. Your full name is required to process this application or permit. <br /> \\����✓J ���- c F / c� �P r' -�— <br /> First Middle Last <br /> � �{i �� �UU�� V t V� �' <br /> Addr ss <br /> �-,v�� ��}��� f1/�N- S5� �' ��..�- �ir3 .��J �i <br /> City Statc 7,ip Phonc <br /> 1 understand my rights as stated above. <br /> � �� �- � _ <br /> �gnature <br /> Reset Form 32 <br />